Publications

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• TANF Caseload Reduction Report Request for Comments

  Pursuant to federal regulations at 45 CFR § 261.40 et seq., the Connecticut Department of Social Services is seeking public review and comment on the methodology and the case number estimates used in its Temporary Assistance for Needy Families (TANF) Caseload Reduction Report to calculate the state’s TANF Work Participation Rate for Federal Fiscal Year 2020.

• TANF_Caseload_Reduction_Report_2017

  The State of Connecticut, Department of Social Services is required to complete and submit annually Form ACF-202, the Caseload Reduction Report for the Federal Fiscal Year (FFY), to the U.S. Department of Health and Human Services, Administration for Children and Families, in accordance with federal regulations at 45 CFR 260 et seq.

• Therapeutic Diet Request W-351

  Therapeutic Diet Request.

• Vendor Direct Deposit Form W-260

  Vendor Direct Deposit Form

• W-0016RR

  Client Rights and Responsibilities - W-0016RR Rev 1-23 - English

• W-0016RRS

  Client Rights and Responsibilities - W-0016RRS Rev 1-23 - Spanish

• W-0534FH

  W-0534FH Fair Hearing Notice - Rev. 05-23

• W-0534FHS

  W-0534FHS - Audiencia Imparcial - Rev. 05-23

• W-1225

  Request for Replacement SNAP Benefits

• W-1225S

  Request for Replacement SNAP Benefits - Spanish

• W-1226

  Proof of Food Loss Form

• W-1226S

  Proof of Food Loss Form - Spanish

• W-300MED

  W-300MED - For Medicaid for the Employed Disabled - Rev. 12-19

• W-300SA

  W-300SA - Medical Report For SAGA Cash Benefits - Rev.12-19

• W-300T19

  W-300T19 - Medical Report For Title XIX Disability Determination - Rev.12-19